Objective: The aim of the present study was to investigate whether copper, zinc and iron levels and copper/zinc, iron/zinc, iron/copper ratios in serum and erythrocytes are associated with lipid oxidation levels, metallothionein-1 (MT-1), and metallothionein-2 (MT-2) levels in plasma in the context of pathogenesis of the mitral chordae tendineae rupture (MCTR). Methods: 65 subjects who were identical in demographic characteristics' were selected for the study; 33 with MCTR patients, and 32 healthy control subjects. The levels of MT-1, MT-2, and malondialdehyde as measure of lipid oxidation, and trace elements were determined by enzyme-linked immunosorbent assay, spectrophotometric method, and inductively coupled plasma optical emission spectrometry, respectively. Results: Serum zinc levels were found to be lower in the patients' group when compared to control group. The copper and iron levels in serum, MT-1, MT-2; malondialdehyde levels in plasma, iron and malondialdehyde levels in erythrocytes; serum copper/zinc and iron/zinc ratios were found to be higher in the patients' group when compared to controls. Conclusions: We conclude that the changes of oxidant antioxidant system balance and trace element status may contribute to the etiopathogenesis of MCTR.